Mapping of the Private Health Sector Players and Partnerships in Uganda
Introduction
The private health sector is highly diverse with significant problems and constraints,
particularly fragmentation, poor coordination and lack of resources, which are significantly
undermining its performance. In their efforts to find solutions to some of these problems,
private health service organizations and institutions need to establish partnerships with stakeholders and development partners, which provide opportunities for capacity building, training, technical exchange programs, long-term sustainability
of health system
strengthening of these
organizations.
However, most of these partnerships are not
properly coordinated at both the organizational and sector levels, and do not therefore fully address
the sector priorities. In view
of the foregoing, private health sector
need to develop an
appropriate strategic framework for the promotion, coordination and
management of these partnerships,
so as to focus them at sector priorities and realize
their full potential. This will improve resource efficiency, sustainability and avoidance
of duplication.
Given this background, Uganda
National Association of Private Hospitals (UNAPH)
and other private health subsector organizations need to conduct a transparent mapping of
the private health subsector organizations in Uganda. This policy brief presents the findings
of the mapping and recommendations on the potential areas for
partnerships.
Existing Health Partnerships
The mapping
established the following:
§ Some private health sector organizations in Uganda have successfully established
partnerships with development partners and international organizations from various
countries;
§ The concept of partnership is not widely understood and clearly applied by most
private health sector organizations
in Uganda;
§ The presumptive umbrella organizations do not fully address and represent issues of their
members, have competing
tendencies against their subordinates and sometimes
overlap their objectives;
§ The partnerships are mainly concentrated in some regions, few organizations and
institutions while
majority of the institutions
do not have partnerships;
§ The
vertical and horizontal partnerships tend to be opportunistic;
§ Government should retain the responsibility of transparent coordination, stewardship and identification of private health subsector players and not throw it all to a
private
player;
§ There is continuing unethical behavior of private sector associations which might
abuse the partnership concept;
§ There
is
unclear framework to guide
and promote
the
targeting,
establishment, coordination, monitoring
and evaluation of partnerships, particularly at
sector
level.
Potential Areas for Partnerships
All the organizations identified by the mapping program acknowledge the importance of partnership and express interest in developing
appropriate partnerships with development
partners and government. On the other hand, most of the major problems faced by these organizations are
similar, and as such, the potential
areas for partnerships are mostly generic. Actual scoping of
focus areas for each individual subsector level association should
be based on the priorities
and
status of the particular
institution, and on gap filling basis.
Proposed
Process for Identifying Partnerships
In order to improve
the coordination and management of partnerships,
it is proposed that
the process of identifying priority areas for partnerships should be linked to the health
sector planning process and be aligned to the national health strategic plan. The process
should form part of each institution’s medium
term expenditure framework (“MTEF”)
and
annual action planning process. Further, implementation
of partnership activities should be managed in a transparent and accountable manner, and captured under the monitoring
and
evaluation arrangements, which are in practice within MOH and the
respective institutions. Consistence adherence to sector objectives and priorities
is key, coupled
with
integrity and corporate ethical behavior.
Currently
Identified Key Private Health Subsector Players
1. Faith-Based
Medical Bureaus (PNFPs)
i.e
Catholic,
Protestants,
Muslim and
Orthodox
2. Private for Profit (PFPs)
Hospitals i.e
Private
hospital
associations (Independent private hospitals and private
medical clinics), etc
3. Health
CSOs / NGOs
4. Health Marketing organizations /
Companies / Individuals
5. Social Franchises
6. Corporate Companies
and
Business Chambers of Commerce
7. School Health – Private Schools
8. Health Innovations – IT
/ HMIS
9. Private Medical Laboratories
10. Private
Health Training Institutions
11. Traditional
Medicines
12. Herbal
Products / Food Supplements
13. Pharmacies
14. Health Insurance Companies
15. Private
community health organizations
16. Medical Equipment Suppliers
17. Health
/ Medical Publishers
/ Communications /
Health Journalists
18. Private
Health Consultancy firms/ Research
19. Medical
Waste
and Environmental health
20. Health Lawyers
/ Legal
Experts
21. Public Health companies and organizations
22. etc
Conclusion
Even though the concept of partnership has not been widely understood and transparently
applied in the
Ugandan private health sector, some organizations have established
significant numbers of partnerships.
It is
generally acknowledged that, if
properly planned and managed, partnerships
provide significant opportunities for health sector strengthening, capacity
building and for long-term sustainable development. Almost
all
private organizations have interest in developing partnerships. The mapping will provide a sound basis for the development of an appropriate strategic framework for planning, coordination and management of partnership, which is urgently needed for the
sector to realize full
benefits from the
partnerships. Partnerships
should be integrated
with the local health systems and strengthen the national health system and not foster
dependency and fragmentation.
The integration into existing health systems is essential
for sustainability, local empowerment
and public health management.
Uganda National Association of Private
Hospitals (UNAPH) P.O.Box 29324 Kampala,
Uganda.
Email: unaph22@yahoo.com, unaphserv@gmail.com Website: www.unaph.org www.ugandaprivatehospitals.blogspot.com
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